Showing posts with label OIG. Show all posts
Showing posts with label OIG. Show all posts

Friday, March 7, 2014

Does the OIG's "Extend The DRG" report make no sense, or did I miss something?

In February 2014, the OIG published a report whose whose title seems to clearly predict its content:  "Medicare and Beneficiaries Could Realize Substantial Savings if the DRG Window were Expanded."  (For a brief summary of the 32-page document, see this blog.)

What happens now? 
The report notes that a pre-admission bundling policy currently exists for hospital services within a three day window and provided by the same hospital.  For three days before a DRG inpatient admission, services of the very same hospital are considered bundled (these might typically be emergency room services or pre-surgical laboratory tests).  No post-discharge services are overtly bundled, but a quirk for clinical laboratories called the "date of service rule" blocks additional payment for tests performed on samples taken while the beneficiary was an inpatient.